An 82-year-old nursing home resident is seen on monthly rounds. The floor nurse points out the skin lesions shown here. The patient is asymptomatic. Appropriate management includes
A) Punch biopsy
B) Topical 5-fluorouracil cream
C) Cryotherapy
D) Hydrocortisone cream
E) Observation
Answer: The answer is E. (Observation)
Discussion: Seborrheic keratoses are common skin lesions that affect the elderly. They tend to run in families. The average diameter is 1 cm, but they can grow to 3 cm in diameter. The lesions are brown or black, oval in shape, raised, and have a “stuck on” appearance.
They most commonly occur on the face, back, neck, and scalp. They may appear suddenly and become pruritic and crusted. Numerous lesions that appear rapidly may signal the development of an underlying malignancy.
Treatment is cosmetic and usually reserved for those that are inflamed or causing symptoms.
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